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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ST. JUDE MEDICAL SWARTZ¿ BRAIDED TRANSSEPTAL GUIDING INTRODUCER SL 1 CURVE, 63 CM LENGTH, 8F; INTRODUCER, CATHETER

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ST. JUDE MEDICAL SWARTZ¿ BRAIDED TRANSSEPTAL GUIDING INTRODUCER SL 1 CURVE, 63 CM LENGTH, 8F; INTRODUCER, CATHETER Back to Search Results
Model Number 407439
Medical Device Problem Code Material Puncture/Hole (1504)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 06/10/2024
Type of Reportable Event Malfunction
Event or Problem Description
During a cryoablation, transseptal puncture was performed with a brk needle through a swartz sl1 sheath, and a slight resistance was felt.A visual inspection of the sheath revealed a perforation was made.A new brk needle and swartz sl1 sheath was then used.The same resistance was experienced and when the brk needle was removed, it was found that the sheath was once again perforated.The transseptal puncture was successfully performed on the third attempt with another replacement of the brk needle and swartz sl0 sheath.
 
Additional Manufacturer Narrative
The results of the investigation are inconclusive since the device was not returned for analysis.The device history record was reviewed to ensure that each manufacturing and inspection operation was performed.Based on the information received, the cause of the reported insertion difficulty and a perforation of the sheath could not be conclusively determined.
 
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Brand Name
SWARTZ¿ BRAIDED TRANSSEPTAL GUIDING INTRODUCER SL 1 CURVE, 63 CM LENGTH, 8F
Common Device Name
INTRODUCER, CATHETER
Manufacturer (Section D)
ST. JUDE MEDICAL
5050 nathan lane north
plymouth MN 55442
Manufacturer (Section G)
ST. JUDE MEDICAL
5050 nathan lane north
plymouth MN 55442
Manufacturer Contact
wendy mccarty
5050 nathan lane north
plymouth, MN 55442
6517565400
MDR Report Key19644694
Report Number3005334138-2024-00243
Device Sequence Number20472450
Product Code DYB
UDI-Device Identifier05414734205634
UDI-Public(01)05414734205634(10)10157519(17)261231
Combination Product (Y/N)N
Initial Reporter CountryGM
PMA/510(K) Number
K052644
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Foreign,Health Professional,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial,Followup
Report Date (Section B) 10/31/2024
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Operator of Device Health Professional
Device Model Number407439
Device Catalogue Number407439
Device Lot Number10157519
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 06/12/2024
Supplement Date Received by Manufacturer10/08/2024
Initial Report FDA Received Date07/01/2024
Supplement Report FDA Received Date10/31/2024
Was Device Evaluated by Manufacturer? (Y/N) No
Is the Device Labeled for Single Use? (Y/N) Yes
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Initial
Patient Sequence Number1
Concomitant Medical Products
and Therapy/Usage Dates
SWARTZ¿ BRAIDED TRANSSEPTAL GUIDING INTRODUCER.
Patient SexUnknown
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